3 DENGUE DEATHS

After two years, Trinidad and Tobago (TT) is again grappling with a dengue outbreak.

The Health Ministry has received reports of five deaths out of which three have been confirmed as due to dengue haemorrhagic fever. There are approximately 600 clinical cases reported. Dengue fever is caused by an infected female Aedes aegypti mosquito.

At a press conference at the Health Ministry, Park Street, Port-of-Spain yesterday, Chief Medical Officer Dr Anton Cumberbatch said, “The rate of the increase is at an outbreak rate. We may not have reached the numbers as before but we have to be clear that you have an outbreak going on.” In the 2008 outbreak there were more than 3,000 clinical cases and six deaths.

Cumberbatch said there could be more than 600 cases (for the year so far) since the data recorded came from the public health service. Private facilities do not report directly to the ministry. Figures are collected from an “indicator” private health practitioner as part of the overall “epidemiological tracking.”

The media have been receiving reports of dengue in different parts of the country from Alyce Glen, Petit Valley in the West, Sangre Grande in the East, Morgua and Williamsville in the South.

Cumberbatch said of the five adults who died, four were from south Trinidad. One confirmed case is from east Trinidad. Health Minister Therese Baptiste-Cornelis has asked for reports on the cases to see if there were any links and to find out if there were any “errors in detection at the point at which they entered our system.” She expects to have the report by next Friday.

Cumberbatch stressed that a dengue outbreak was not needed for people to die of dengue.

“We don’t want people living in Morvant or Diego Martin to feel because you do not have a cluster of cases you are safe.”

He said with repeated cycles of infections over the past 30 years many citizens have experienced some form of dengue fever. “The more often you get dengue fever is the more likely you will get complications. Our children are particularly at risk.” The ministry has also observed that the cycle of high infections has changed from five years to two years.

Cumberbatch said, “The rainy season lasts until December so we are in July this is not going to go away any time soon. We are in for the long haul. If we continually manage our environments and our homes we will not be standing here and speaking to you of dengue over and over.”

The symptoms of dengue fever are: high fever, headache, joint and muscle pain. These symptoms can last seven to ten days. Cumberbatch said while the fever may decrease on the fifth day if there is still abdominal pain and vomiting after three to four days, persons should seek emergency care. Bleeding under the skin is also a sign which persons should be vigilant. Cumberbatch said, “You don’t want to see bleeding of the nose and mouth. If you are not feeling well come to us early.”

He advised the public to heed the advice of doctors at public health facilities when they are told to return for follow-up care. Cumberbatch said people should not get impatient and leave health facilities without being seen. “We don’t want you to go home in exasperation and do the wrong thing.”

While there may be a waiting period he reminded that the public health system also had to cope with many other medical conditions including cases resulting from “violence and trauma in the society.”

While there are calls for more spraying to deal with mosquitoes, Cumberbatch said spraying only killed adult mosquitoes not the larvae or eggs left to hatch. He called for the public to pay attention to environmental conditions.

Baptiste-Cornelis spoke of the integrated approach for managing dengue. She said resources are being mobilised to respond and an additional 60 sprayers had been hired by the Insect Vector Control Division (ICVD). Guidelines and polices are to be implemented by the ministry, IVCD, and regional health authorities (RHAs). “Our CMO will be meeting with the private Doctors Association to brief them more on the policies we deem acceptable.”

Paula Chester Cumberbatch, CEO of the South West RHA, reported that for June, 62 persons were treated for dengue while for July, 161 persons were treated. She said key areas of concern were: Marabella, San Fernando, Claxton Bay and Gasparillo.

Judith Ramoutar, Acting CEO of the North West RHA, reported that four suspected cases of dengue were being seen on a weekly basis and “some” were positive.

It is believed that the confirmed death in east Trinidad was that of Anushka Buchoon who died on June 22 at the Sangre Grande Hospital. She lived at Guaico.

Her brother Roshan yesterday complained about the care Anushka received when she was admitted on June 21. He said a Nigerian doctor told the family she had a chest infection and she was warded. By 4 am the next morning Anuskha had died. The death certificate said she succumbed to dengue haemorrhagic fever.

Residents of Moonlight Avenue, Mulchand Street, St Anies Street along the Guaico Tamana Road, Sangre Grande claimed they had several relatives who were being treated for dengue.

Some are hospitalised, while others are receiving private medical attention. The residents said not enough is being done to curb the spread of the disease.